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Biomedical subjects

F Grisoli

Publications and source records attributed to F Grisoli.

At least 109 records · Page 6Linked to original sources
PubMed1993

[Neurological form of cryptococcosis. Apropos of 2 atypical cases in non HIV-infected patients].

Cryptococcal infection is the most common fungal infection of the central nervous system. More than 50% of the cases of cryptococcal infection are superimposed on an immunosuppressive or other general debilitating condition. Cerebral cryptococcosis usually presents as meningitis or meningoencephalitis, although cerebral granuloma has also been reported. Hydrocephalus is the most common neurosurgical complication of cerebral cryptococcosis. The majority of patients require only medical treatment with antifungal drugs. However, when complications ensue, surgical intervention is mandatory. We suggest that chronic meningitis be ruled out in all patients prior to the placement of shunts. In the two cases reported here treatment of cryptococcal meningitis was a combination of amphotericin B and flucytosine for six weeks. Fluconazole is a new alternative and at least as effective as amphotericin B.

Adolescent↗
PubMed1992

Minocycline and benign intracranial hypertension.

A case is reported of a 16-year-old girl who developed benign intracranial hypertension, with severe bilateral papilledema after minocycline therapy. A lumboperitoneal bypass was carried out in view of the ophthalmologic signs and the pressure of cerebrospinal fluid.

Adolescent↗
PubMed1992

Ectopic intrapelvic medulloepithelioma: case report.

A primary extraspinal medulloepithelioma with lung metastases is reported. The tumour was located in the presacral area. Microscopically, it showed typical features of medulloepithelioma with focal ependymal differentiation. Medulloepitheliomas are malignant tumours of primitive neuro-epithelium usually involving the cerebral hemispheres. This report demonstrates their possible extraspinal presacral occurrence. By immunohistochemistry, neuron-specific-enolase, S100 protein, vimentin, cytokeratin and glial fibrillary acidic protein were found in some tumour cells. Electron microscopy demonstrated poorly differentiated cells forming stratified epithelium resting on a basal lamina and short junctional complexes at the apical pole. Ultrastructural evidence of ependymal differentiation was observed. Presacral medulloepithelioma may arise from undifferentiated embryonic cells forming the presacral remnants of the neurenteric canal.

Adolescent↗
PubMed1992

Telomeric association of chromosomes in human meningiomas.

In six cases of meningiomas, a karyotype with monosomy 22 and telomeric associations has been observed. The histopathological and cytogenetic correlations showed that the tumors with these chromosomal abnormalities were of a fibroblastic type and presented a certain degree of anaplasia. The relationship between telomeric association and malignancy is discussed.

Chromosomes, Human↗
PubMed1992

[Transient Korsakoff's syndrome after intraventricular hemorrhage].

A 42 year-old man with intraventricular haemorrhage developed a transient Korsakoff's syndrome. A small arteriovenous malformation was identified on the inner side of the left parietal lobe. Cognitive disorders are very frequent after surgery on anterior communicating artery aneurysms, more rarely when the haemorrhage interest the axial anatomic loci implicating in the process of amnesic syndromes. This case illustrates well the possibility of transient Korsakoff's syndrome after pure intraventricular haemorrhage.

Adult↗
PubMed1992

[Lacunar syndromes due to intracerebral hemorrhage].

Nine cases (seven men and two women, mean age 64.5 years) of classical lacunar syndromes due to intracerebral hemorrhage are reported. Three patients presented with pure motor hemiparesis (two putaminal hematomas with proportional weakness and one cortical hemorrhage with brachio-crural hemiparesis). Four patients presented with sensorimotor stroke due to thalamo-capsular hemorrhage. The last two patients had thalamic hemorrhage causing ataxic hemiparesis or dysarthria-clumsy hand syndrome. Four subjects had arterial hypertension, one was diabetic, and two were treated with anti-vitamin K. Abrupt onset was noted in all instances. Only one patient experienced moderate inaugural headaches. Good recovery occurred in all cases. Lacunar syndromes are a very uncommon presentation of intracerebral bleeding. Hemorrhages are yet the second etiology of such syndromes. Distinguishing hemorrhage from infarction is not clinically possible and needs early unenhanced CT scan.

Aged↗
PubMed1991

Severe fibromyalgia after hypophysectomy for Cushing's disease.

We report a case of fibromyalgia occurring after hypophysectomy for Cushing's disease. Clinical examination revealed tender points at 12 of the 18 tender point sites described in the American College of Rheumatology 1990 criteria for the classification of fibromyalgia. The cause of fibromyalgia remains unknown. In our patient, hypophysectomy may have played a role by disturbing endorphin secretion and pain modulation.

Cushing Syndrome↗
PubMed1991

Anomalies of the P1 segment of the posterior cerebral artery: early bifurcation or duplication, fenestration, common trunk with the superior cerebellar artery.

In a series of anatomical dissections on 100 fixed human brains, 3% of anomalies of the precommunicating segment of the posterior cerebral artery (P1) were found, among which a case of duplication of the P1 segment. This finding is very unusual and it is much rarer than the many other anatomical patterns reported in the circle of Willis. It is to be considered a very early bifurcation, as reported at the middle cerebral artery level. Another two unusual anatomical patterns were found. One was a large fenestration of the P1 segment, which is rather frequent in the vertebrobasilar system. The other was a bilateral common trunk between the posterior cerebral artery and the superior cerebellar artery, which represents a rare anatomical variation. The existence of such "anomalies" can be explained by the embryological development of the region. Their pathogenic and neurosurgical implications are discussed in the light of the literature.

Arteries↗
PubMed1991

Extracerebral course of the perforating branches of the anterior communicating artery: microsurgical anatomical study.

Damage to the perforating branches arising from the anterior communicating artery, because of their blood supply to the septal nuclei and anterior hypothalamus, explains the memory impairment and the electrolyte disturbances that often follow the surgery of aneurysms located in this part of the circle of Willis. The microsurgical anatomy of these branches was studied on 60 fixed human brains, with special attention to their number, caliber, and vascular territory. The direction of the branches was evaluated, measuring the angle formed by them with the postcommunicating segment of the anterior cerebral artery. The variability of this anatomical region is discussed in light of the literature.

Cerebral Arteries↗
PubMed1991

Malignant transformation of an osteoblastoma of the skull: an exceptional occurrence. Case report.

What is apparently the first reported case of spontaneous malignant transformation of a benign osteoblastoma of the skull is described. The initial lesion was completely removed surgically and showed the histological features typical of a benign osteoblastoma. No radiotherapy was performed. Eleven years later the patient developed an osteosarcoma of the skull. Review of the literature showed that malignant transformation of benign osteoblastomas is extremely rare and could take place spontaneously. However, the risk of this occurring seems higher after inadequate initial treatment (curettage or partial excision). Follow-up monitoring of patients with osteoblastoma of the cranial vault is suggested.

Adult↗
PubMed1991

[Vertebrobasilar arterial dolichoectasia. Complications and prognosis].

Symptomatic dolichoectasia of the vertebrobasilar system was found in 23 patients (16 males and 7 females, mean age: 62 years) during a 13-year period. Arterial hypertension was noted in 20 cases and associated aortic ectasia in 4. The malformation was identified in all patients on CT completed by angiography in 19, MRI in 7. Autopsy was performed in 5 cases. Fourteen subjects (group 1) presented with a vascular event (ischemic in 13) affecting the brainstem and/or cerebellum. Nine other patients (group 2) had a chronic symptomatology resulting from compression of the cranial nerves, central nervous system and/or CSF pathway. Two patients died of stroke within the first month (rupture of the ectasia in one and occlusion in the other one). The 21 survivors were followed for a mean period of 45.3 months. Eight patients had a stroke, with a significantly higher incidence in group 1 than in group 2 (p less than 0.05). Ten patients (5 in each group) developed progressive dementia possibly resulting from multiple cerebral infarction, hypertensive leucoencephalopathy, and/or hydrocephalus. Twelve patients died during the follow-up (4 of stroke, 6 of profound mental and motor deterioration, one from ruptured ectatic aorta, and the last one of unrecognized cause). The actuarial survival rate was 60% after 3 years of follow-up. Except for the incidence of stroke, inaugural manifestations (stroke vs nervous compression) did not seem to influence the long-term prognosis.

Actuarial Analysis↗
PubMed1991

[High resolution NMR spectroscopy of CSF: methodological issues and perspective clinical applications].

High resolution proton nuclear magnetic resonance (NMR) spectroscopy is a new analytical technique which allows to readily identify and quantitate a variety of key metabolites in cerebrospinal fluid (CSF) in relation to normal and pathological brain activity. Proton NMR spectroscopy can be performed on native CSF, with or without addition of exchange reagent (NH4Cl). The analysis of native CSF provides qualitative information (identification) of metabolites or xenobiotics present in the fluid. Alternately, CSF can be lyophilized and dissolved in deuterated water. This concentration offers 2 advantages: additional compounds are detected and a precise quantification of all CSF metabolites can be obtained. Both protocols require a very small volume of CFS (1-2 ml). The high informational content available on the NMR spectra of CSF, the ease-of-use of NMR spectroscopy and its cost effectiveness concur to predict that this analytical approach will keep developing to completement the array of existing tests which are already routinely performed on CSF.

Central Nervous System Diseases↗
PubMed1991

A new approach of brain tumors: the cytogenetic study.

Cytogenetic studies of brain tumors in adults have made it possible to determine specific chromosomal abnormalities and to detect a high incidence of gene amplification related to these abnormalities. Data from the literature and our own results show frequent numerical deviations in glioblastomas, such as gain of chromosome 7, but also 19, 20 and X, loss of certain chromosomes: monosomies 6, 14 and 22. Most of the structural abnormalities are deletions involving the chromosomal regions 1p, 6q, 7q and 9p, and the presence of double-minutes (DMs), the latter being the chromosomal expression of EGFR gene amplification. Cytogenetic analysis of meningiomas has shown that some of them have monosomy 22 alone while others have additional abnormalities. Antioncogenes probably play a part in these tumors. Their identification will explain the neuro-oncogenesis process and perhaps open a new route for the treatment of brain tumors.

Adult↗
PubMed1991

Magnetic resonance imaging in gangliogliomas and gangliocytomas of the nervous system.

Gangliogliomas and gangliocytomas are rare and benign neuronal tumors which affect young subjects. This study concerns 3 cases of ganglioglioma and 3 cases of gangliocytoma explored by CT and MRI and confirmed by pathological examination. The most typical CT image was that of an often calcified contrast-enhanced cystic tumor. At MRI, each tumor emitted a low-intensity signal on T1-weighted sequences and a high-intensity signal on T2-weighted sequences. Contrast enhancement after gadolinium injection was frequent. Neuroradiology is not specific, and these tumors are usually diagnosed at pathology. However, the diagnosis may be considered in young patients with a history of old, drug-resistant partial epilepsy and having a contrast-enhanced, calcified cystic lesion in the temporal lobe or the cerebellum.

Adolescent↗